Can GPs use smoking status data in electronic health records to recruit patients for lung cancer screening? A descriptive study using the MedicineInsight database

Background: In 2025, lung cancer screening commenced in Australia, with general practitioners (GPs) being patients’ first point of contact to access the program. However, there is a gap in understanding how GPs can effectively identify screening-eligible individuals. Therefore, our study examined how smoking status data are recorded in GPs’ electronic health records (EHRs), describing differences in smoking status data by socio-demographic characteristics and co-morbidities, and identifying missing data in EHRs. Methods: A cross-sectional study was conducted. We investigated 1,366,586 regular adult patients attending general practices in the MedicineInsight database, between 1 July 2021 and 30 June 2022. We assessed patient-related information as proportions, including ‘current’ smoking status, socio-demographic characteristics, co-morbidities, and the number of cigarettes smoked per day amongst smokers. Results: In our study, 156,881 (11.5%) regular adult patients were recorded as smokers, 311,503 (22.8%) as ex-smokers, 766,091 (56.1%) as non-smokers, and 132,111 (9.7%) did not have smoking status recorded. Smoking status data was better recorded in older age groups, including the lung cancer screening-eligible population of 50–70-year-olds. Lower socio-economic areas and remote/ very remote areas had higher rates of smokers and ex-smokers. Co-morbidities such as chronic obstructive pulmonary disease, diabetes and cardiovascular disease had higher rates of current and ex-smokers, compared to non-smokers. EHR recording of cigarettes smoked per day were limited to only 776 smokers. Conclusions: Our study indicates that GPs can use their EHRs to help recruit patients for LCS, as ‘current’ smoking status was recorded for over 90% of regular patients. However, GPs need to further assess these patients for screening eligibility, as detailed smoking history data were poorly recorded. Priority populations for GPs include those from lower socio-economic and remote/ very remote areas, and with certain co-morbidities. GPs need to be better supported, especially with adequate funding, given the additional workload and time required.